Dental Health After Childhood Cancer

Taking care of your teeth and gums is important for everyone. But it is even more important for survivors of childhood cancer who received certain types of cancer treatment that raise risk for dental problems.

Am I at Risk?

If you received the following cancer treatments you are at risk for dental problems:

chemotherapy before your permanent teeth were fully formed, especially if you were younger than 5 years old

What Can I Do To Prevent Dental Problems?

Take good care of your teeth and gums, and see your dentist routinely to prevent cavities and gum disease. Follow these recommendations, unless your dentist tells you otherwise.

See your dentist at least every six months. Your visits should include oral cancer screening.

Have a panorex x-ray done before dental or orthodontic procedures to assess root development of your teeth and determine if any changes need to be made to your dental treatment plan.

Brush your teeth at least twice a day using fluoride toothpaste. Brush at a slight angle toward the gum when brushing along the gum line.

Gently floss your teeth once or twice a day.

Use antibacterial, alcohol-free fluoride mouth rinses.

Drink liquids often, use artificial saliva, or both.

Apply fluoride rinses or gels daily, if recommended by your dentist.

Limit sweets and foods high in carbohydrates.

Don’t use tobacco products and use alcohol in moderation, if at all. Alcohol can increase risk for other problems following childhood cancer, so ask your doctor first. Also, tobacco in any form, especially with alcohol, greatly increases your risk for oral cancer.

Tell your dentist right away if your mouth or gums are red, tender, or bleeding a lot, or if your teeth hurt or have increased sensitivity. These are signs of infection.

Notify your dentist right away if you notice a sore that does not heal or that bleeds easily; a change in the color of your mouth tissues; a lump, thickening, or rough spot in your mouth; or pain, tenderness, or numbness in your mouth or on your lips. Though unlikely, these symptoms can be signs of oral cancer.

What If I Have Dental Problems?

Treatment options for dental problems vary. If your permanent teeth do not develop normally, you may need caps or crowns to improve their function and your smile. Sometimes surgery is needed to correct poor bone growth of the face or jaw. Stretching exercises for the jaw may help you to open your mouth more fully. Bonding may help improve crooked or small teeth. If you need braces, your dentist will take a panorex x-ray to see if the teeth, roots, and supporting bone are strong enough. If you had high-dose radiation to the face or mouth your dentist will review your potential for bone healing problems (osteoradionecrosis) following dental surgery. If you had a bone marrow or stem cell transplant from a donor other than yourself, your dentist will check for changes that indicate chronic graft-versus-host disease.

Drinking liquids often and using artificial saliva can help relieve symptoms of dry mouth.

What Should I Talk with My Dentist About?

Give your dentist a summary of your cancer treatment to make sure that he or she knows your health history and the cancer treatments that you received.

Also, be sure to let your dentist know if you have had the following health conditions or procedures:

a shunt that drains fluid from the brain

replacement of bone with a metal rod or bone graft (limb salvage procedure)

a leaky or scarred heart valve (sometimes happens after radiation to the chest)